Ophthalmology Quiz

Prepared by Herbert L. Fred, MD, Professor of Medicine, Dan Vaisman, MD, Fellow in Cardiology, The Texas Heart Institute, and Judianne Kellaway, MD, Associate Professor of Ophthalmology, Departments of Internal Medicine and

Ophthalmology, The University of Texas Health Science Center, Houston

Case 1

An 84-year-old woman presented with a 4-month history of painless swelling of all 4 eyelids (Figure 1). On physical examination, the lids felt boggy, and each eye had pinkish-pale, lobular tissue covering almost the entire bulbar and palpebral conjunctiva (Figure 2). Generalized lymphadenopathy and mild normocytic, normochromic anemia were additional findings.

Case 2

A41-year-old woman complained of a scratchy sensation in her right eye of 3-months' duration. On external inspection, her eyes appeared normal, but raising the right upper lid unveiled a salmon-colored conjunctival mass (Figure 3). Physical examination was otherwise unremarkable, and results of conventional laboratory studies were normal.

Both patients have the same disease.

What's the Diagnosis?

• Sarcoidosis
• Vernal keratoconjunctivitis
• Conjunctival lymphoma
• Amyloidosis

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